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Snakebite now a severe threat to public health

Victims suffer for lack of costly anti-venom injection


Jubair Hasan and Yasir Wardad | Published: July 25, 2019 10:44:16 | Updated: August 03, 2019 14:35:52


Photo collected from internet has been used for representational purpose only

Snakebite has emerged as a severe threat to thousands of people across the country, especially in the flood-hit areas, due to inadequate supply of the expensive drug, used to counter snake venom, officials and experts said.

The situation turned too critical for local administration to tackle, as eight people reportedly died and 43 others were injured in snakebite over the last two weeks in the waterlogged areas.

According to them, the government can supply maximum 6,500 vials (small bottle to store liquid medication) of anti-venom, including 5,000 vials donated by the World Health Organization (WHO).

But, it can netutralise snake venom of less than 700 victims out of 0.7 million, as it requires 1-20 vials to neutralise a snakebite. In Bangladesh, there are instances of using more than 100 vials for a single victim, according to the sources.

At the same time, a local pharmaceutical company is also manufacturing a small portion of the anti-venom, which is insignificant in terms of the total demand. Its price hovers between Tk 1,100 to Tk 1,400 each vial in the retail level that is also very expensive.

According to a 2018 report of the WHO, some 0.7 million people annually fall victim to snakebite in Bangladesh, and more than 6,000 of them die.

Snakebite is the second highest cause of death during flood when snakes slither out of their habitats and take shelter in human homes, the WHO report mentioned.

Some 80 species of snakes are found in the country, and 27 of them are venomous, of which 12 are sea snakes, according to the Non Communicable Disease Control (NCDC) Programme under the Directorate General of Health Services (DGHS) that deals with the supply of anti-venom.

When contacted, the NCDC line director Dr. Nur Mohammad said they imported 1,500 vials of anti-venom through the state-owned Essential Drugs Company Limited (EDCL), while the WHO donated them 5,000 vials.

Talking about the anti-venom supply, he said they distributed 100 vials to each district sadar hospital, while a bunch of 200 vials were supplied to each medical college and hospital in the country.

"The district hospitals supplied the drug to upazila health complexes at free of cost depending on their demand."

But the problem arises at the upazila level, where the physicians do not feel quite confident in treating the snakebite victims because of unavailability of the required shock management facility, and referred them to sadar hospitals.

"The patients might experience anaphylactic shock during treatment. But the upazila health complexes do not have shock management facility like Intensive Care Unit (ICU)," Dr. Mohammad added.

However, the government does not prioritise the snake-prone areas in distributing the liquid anti-venom medicine.

Deputy Programme Manager of the NCDC Dr. Md. Rajib Al-Amin said the WHO supplied Indian polyvalent anti-venom, which can neutralise antigens of five venomous snakes.

"But the problem is that the venomous snakes in India are quite different from those of Bangladesh. So, the anti-venom does not work in many cases," he said.

Under Fourth Health Nutrition and Population Sector Programme (HNPSP), the NCDC along with the Chittagong Medical College and Hospital and the Chittagong University Department of Zoology is hatching poisonous snakes in a laboratory of the Venom Research Centre to develop a special anti-venom for Bangladesh that can neutralise venoms of all deadly local snakes.

Meanwhile, the FE correspondents talked with the sadar hospital authorities in Gaibandha, Jamalpur and Kurigram, where snakebite has turned into a severe problem in the recent days.

Gaibandha civil surgeon Dr. A B M Abu Hanif told the FE that there is no anti-venom in the hospital.

Jamalpur civil surgeon Dr. Gautam Roy also said they have inadequate supply of anti-venom injection in the hospital. Only 35 doses of anti-venom were supplied for seven upazilas by the central medical store of the Ministry of Health.

"But not a single dose has been used yet. We've received information of many snakebites in the district. The victims might have gone to snake-charmers or quacks to cure snakebites," he added.

Former Director General of the DGHS Prof. Dr. M A Faiz said the supply of anti-venom is too inadequate in terms of supply that needs to be increased manifold considering snakebite a serious challenge for public health.

At the same time, the upazila hospitals should be empowered with necessary equipments and facilities, so that the physicians feel confident in treating the snakebite victims.

jubairfe1980@gmail.com

tonmoy.wardad@gmail.com

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